Wendy Levinson MD Professor of Medicine University of
- Slides: 16
Wendy Levinson, MD Professor of Medicine, University of Toronto Chair, Choosing Wisely Canada Welch Public Health Conference 2014 October 7, 2014
Total health expenditures as percentage of gross domestic product (1970 -2011) 18 16 14 12 Germany 10 U. K. Canada 8 Japan 6 U. S. 4 2 0 1970 1980 1990 2008 2011 OECD, 2013
Berwick D. JAMA. 2012.
I’ve always done this The patient wants it New tests are good $$ I don’t want to get sued Referring doctor wants it Better to do something than nothing
Choosing Wisely Canada (CWC) is a campaign to help physicians and patients engage in conversations about unnecessary tests, treatments and procedures, and to help physicians and patients make smart and effective choices to ensure high-quality care.
History of the campaign • Choosing Wisely® campaign began in 2012 in US; 70 medical societies are participating • Choosing Wisely Canada launched in April 2014 • More than 30 national specialty societies engaged and at various stages of recommendation development • Choosing Wisely® efforts are also present in countries like Australia, Denmark, England, Germany, Italy, Japan, Netherlands, New Zealand, Switzerland, Wales
Campaign Approach Physicians Patients Media Stakeholders • Societies develop lists • Disseminate through multiple channels • Develop patient materials • Disseminate broadly through multiple channels • Coordinated approach toward media • Multiple voices, a common message • Work through health care stakeholder organizations to implement and support adoption
Putting recommendations into practice
Cedars-Sinai Blind Spot Monitor: CW Embedded in CPOE
The patient wants it How we are taught New tests are good Preemptive ordering Better to do something than nothing Lack of feedback Demonstrate thoroughness
Choosing Wisely Australia Choosing Wisely Canada Doing more does not mean doing better (Italy) Choosing Wisely Japan Choosing Wisely – The Netherlands Smarter Medicine (Switzerland) Choosing Wisely (U. S. ) Prudent Healthcare (Wales)
Principles of a Choosing Wisely Campaign • • • Physician led Patient-focused Evidence-based Multi-professional Transparent
Health care systems Clinical practice Physicians & patients Reduce unnecessary care, harm and waste Partnerships + Integration Shared Decision Making + Implementation Awareness + Education + Engagement
